The St. Croix County Health and Human Services Board met on November 14,
2000, at the St. Croix County Human Services complex in New Richmond, Wisconsin.
MEMBERS PRESENT: Robert Stephens
Leon Berenschot
Chris Bethke
Lois Burri
James Craig
Einar Horne
Fern Johnson
Mary Louise Olson
Esther Wentz
MEMBERS ABSENT: none
STAFF PRESENT: John Borup, Health and Human Services
Director
Carolyn Krieger, Nursing Home Administrator
Judy Ziegler, Accounting Supervisor
Barbara Nelson, Public Health Supervisor-Health Officer
Fred Johnson, Family and Children’s Supervisor
Kathy Dunlap, Family and Children’s Supervisor
Ron Lockwood, Long Term Support Coordinator
Jay Hay, Reproductive Health RN
Malva Berg, Secretary
OTHERS PRESENT: Melissa Gullickson, Social Work Student
Barb Kosterman, Barron County Interim Health Officer
Wanda Viellieux, Long Term Support Committee
Chairman Stephens called the meeting to order at 8:30 a.m. noting the meeting
was properly and legally publicized.
NEXT MEETING: Motion: A motion was introduced by
Berenschot, seconded by
Olson, and unanimously adopted: That the Board agrees to cancel the Health and
Human Services Board meeting scheduled for November 21, 2000 as there are no
agenda items. The next Health and Human Services Board meeting will be Tuesday
December 12, 2000 at 8:30 AM. Horne will review vouchers at 8:00 AM.
AGENDA: Motion: A motion was introduced by
Bethke, seconded by Berenschot, and unanimously adopted: That the agenda be approved as circulated.
MINUTES: Motion: A motion was introduced by
Berenschot, seconded
by Wentz, and unanimously adopted: That the minutes of the 10/26/00 Health and
Human Services Board meeting be approved as circulated.
ANNOUNCEMENT: Borup announced Anyrine Klaasen resigned from the Birth to
Three Advisory Committee and Heather Kittelson has been appointed by Chair
Stephens to replace her.
CONSIDERATION OF CLAIMS: The following reports for October were
distributed to the Board: unemployment, cash report and fixed assets purchased.
Health and Human Services Board member, Johnson, reviewed and questioned the
following October vouchers.
HUMAN SERVICES:
Motion: A motion was introduced by Johnson, seconded by Stephens, and
unanimously adopted: That the following vouchers be approved and be made a part
of the supplemental minute book pages 863 through 971:
Human Services voucher 4317, dated October 12, 2000 in the amount of $842.63.
Human Services voucher 4318, dated October 13, 2000 in the amount of $600.00.
Human Services vouchers 4321 through 4389, dated October 19, 2000 in the
amount of $114,551.39.
Human Services vouchers 4390 through 4391, dated October 20, 2000 in the
amount of $1,350.00.
Human Services voucher 4392, dated October 23, 2000 in the amount of $518.90.
Human Services vouchers 4393 through 4408, dated October 26, 2000 in the
amount of $14,852.47.
Human Services vouchers 4409 through 4465, dated November 03, 2000 in the
amount of $191,199.36.
Human Services vouchers 4466 through 4491, dated November 09, 2000 in the
amount of $110,694.52.
Human Services voucher 4493, dated November 13, 2000 in the amount of
$450.00.
Human Services vouchers 4494 through 4647, dated November 14, 2000 in the
amount of $94,149.57.
Human Services vouchers 4648 through 4786, dated November 14, 2000 in the
amount of $89,613.50.
Nursing Home vouchers 710 through 722, dated October 19, 2000 in the amount
of $21,293.56.
Nursing Home vouchers 723 through 725, dated October 26, 2000 in the amount
of $787.84.
Nursing Home vouchers 726 through 728, dated October 31, 2000 in the amount
of $1,157.39.
Nursing Home vouchers 729 through 732, dated November 09, 2000 in the amount
of $756.97.
Nursing Home vouchers 734 through 788, dated November 14, 2000 in the amount
of $64,120.09.
Human Services and Nursing Home vouchers 526 through 551, dated October 10,
2000, in the amount of $204,354.80.
Human Services, Workshop, Public Health vouchers 492 through 523, dated
October 11, 2000, in the amount of $208,679.43.
Social Services and Human Services vouchers 387 through 407, dated October
11, 2000, in the amount of $74,885.38.
Human Services and Nursing Home vouchers 552 through 575, dated October 24,
2000, in the amount of $156,914.08.
Human Services, Workshop, Public Health vouchers 524 through 552, dated
October 25, 2000, in the amount of $192,005.43.
Social Services and Human Services vouchers 408 through 424, dated October
25, 2000, in the amount of $37,015.89.
Human Services and Nursing Home vouchers 576 through 600, dated November 07,
2000, in the amount of $208,563.41.
Human Services, Workshop, Public Health vouchers 553 through 586, dated
November 08, 2000, in the amount of $250,027.50.
Social Services and Human Services vouchers 425 through 442, dated November
08, 2000, in the amount of $34,866.48.
2001 BUDGET UPDATE: Borup said the County Board approved the budgets on
10/31/00. He said revenue projections remain accurate.
SETTING NURSING HOME PRIVATE PAY RATES: Krieger distributed a survey of
private pay rates of local facilities. She said we are similar to St. Croix Care
Center in Prescott and Christian Community Home in Hudson. She said there is no
set rule as to when to review the rates but private pay clients must be given
30-days notice of rate changes.
Krieger said currently we have 41 empty beds and feels it would be to our
advantage to increase census to convert these empty beds to suites or private
rooms versus two-bed bedrooms.
Motion: A motion was introduced by Stephens, seconded by Wentz, and
unanimously adopted: that the Board approves proceeding with converting some of
the empty beds to private rooms.
Motion: A motion was introduced by Bethke, seconded by
Burri, and
unanimously adopted: That the Board approves the following private pay rates
effective 01/01/01: ISN-$140.00, SNF-$125.00, ICF-$115.00.
Horne asked how many beds Dunn County has and what their loss is.
FINANCIAL REPORT: Horne asked when we will have someone to monitor worker’s
comp. Stephens said Finance asked us not to do anything regarding a worker’s
compensation consultant until there is a county-wide resolution on the matter.
Borup said the year 2000 transfer monies are not included in the following
reports and will check with Hudson accounting department as to when this will
occur. The following reports through September, 2000 were distributed to the
Board:
FAMILY AND CHILDREN’S SERVICES:
Dunlap and Johnson reviewed some of the recommendations coming out of the Kettl
Commission Study. Dunlap said one of the recommendations from the study is to
transition all human services programs to state funding by 2005 and to begin
Family and Children’s pilot programs immediately. These programs would be
similar to W-2 in that counties would have the right of first refusal. She said
the statutes will need to be changed if Family and Children’s Services are
privatized as the statutes now state that a profit cannot be made. Borup stated
that if counties were eliminated as service providers that the State would
potentially lose county "overmatch" dollars, which are substantial.
Johnson said there will be a Federal audit of the Family and Children’s
Programs. Dunlap said according to State people Wisconsin will probably fail
this audit. They will be requesting data based on computer programming that is
not running in most counties now. She said we are mandated to keep records a
certain way and not provided the money or equipment to do this easily. Johnson
said the Kettl Commission is a report and may not be followed through, whereas
the Federal audit is going to happen.
Johnson said two social workers have been hired for Family and Children’s
Unit. There is still one vacant social worker position and one vacant half-time
clerical position.
LONG TERM SUPPORT: Lockwood distributed a study and findings from the
Long Term Support Planning Committee on Waiting List Report and Recommendations.
The study found that there are 170 total unduplicated persons waiting for a
county-funded or administered Long Term Support program. He said of those 170,
20 persons are receiving no other services that Long Term Support records
indicate. Of the 20 persons receiving no services, there are ten who live with
parent or other relatives and ten who live in their own home or apartment. Of
these ten who live in their own home, seven are elderly and referral was made to
the Department on Aging for interim services, if available. Long Term Support
staff will conduct a survey annually of the persons on the waiting list to keep
current services, living situations, risk factors, etc. up to date. Any person
currently on the waiting list who is deemed to be in a potentially life
threatening situation and lack the natural supports necessary to assure safety
is placed at the top of the waiting list.
Stephens said it is the Board’s intention that no one on the waiting list
will suffer and the Board should find monies to meet client needs. Horne asked
how many people are served in these programs and Lockwood said the current
caseload is over 400.
Lockwood distributed the policy on room and board cost of care payments and
earned wages. He said current practice in Mental Health and Alcohol/Other Drug
Abuse unit requires payment from earned as well as unearned income. In Long Term
Support clients are required to pay for room and board from unearned income
only. This proposed policy would also raise unearned income personal allowance
to $100. The current allowance in MH/AODA is $65 and in Long Term Support it is
$65-85. Administration would like to establish a uniform policy that requires
persons receiving residential care services paid for by the county, pay for room
and board from earned income.
Motion: A motion was introduced by Olson, seconded by Wentz: That the
Board approve the Room and Board Cost of Care Payments and Earned Wages Policy
for clients in residential care as presented.
Horne asked why should we bother for the little difference in money this is
going to make. Lockwood said if the client can’t pay, the county has to pay
the costs and this policy would make the policy uniform between Long Term
Support and Mental Health/AODA.
Motion: A motion was introduced by
Berenschot, seconded by Horne, and
unanimously adopted: That the above motion regarding Room and Board Cost of Care
Payments and Earned Wages Policy for clients in residential care be postponed
until the Board has more information.
NURSING HOME: Krieger said the current Nursing Home census is 88 with two
admissions pending.
Krieger said the Board approved purchasing a combi cooker for the Nursing
Home kitchen for $13,000. However, the bid was for an electric cooker and a gas
oven is needed and the cost increased to $15,158. It was the consensus of the
Board that Krieger should go ahead and purchase the gas oven for $15,158.
Krieger presented concerns she has regarding criminal background check
information and whether or not it is in the personnel files. She said if this
information is not in the personnel files at the time of the survey, the Nursing
Home is at risk of being cited. Olson will contact the Personnel office
regarding the concerns.
A joint meeting with Health and Human Services Board and Finance Committee is
scheduled for 12/08/00 to discuss the future of the Nursing Home. Krieger will
do a survey of surrounding nursing homes to establish their anticipated losses
for 2000 and 2001.
NURSING HOME BAD DEBT WRITE OFFS:
Motion: A motion was introduced by Horne, seconded by Olson and
unanimously adopted: That the Board approves the following bad debt write offs
for the Nursing Home: Medicare Part B for $4,424.02 and Medical Assistance for
$1,620.05.
REQUEST FOR 800 TOLL FREE TELEPHONE LINE FOR REPRODUCTIVE HEALTH PROGRAM:
Nelson said the funds for this service will be covered totally by program
generated income, not local tax dollars. She said based on the proportion of
low-income clientele served by this program, providing a toll-free phone line is
one means of assuring access. This line would serve the Reproductive Health
Program only.
Motion: A motion was introduced by Wentz, seconded by
Berenschot, and
unanimously adopted: That the Board approves installing a toll free line for the
Reproductive Health Program.
REVIEW OF RESTAURANT INSPECTION PROCESS: Nelson said as of November, 2000
St. Croix County has 348 licensed establishments. Each establishment pays a
license fee, which currently 100% of this fee goes to the State. If our county
obtains agent status, 90% of the fee stays with the county and 10% goes to the
State. The state may change from providing inspectors to providing training for
local health departments so their agents can provide inspections. Nelson said
persons performing inspections must be a registered sanitarian. She said this
would not be a breakeven program as the license fees would not cover the cost
for the county to have an agent do the inspections. She said it would take at
least one year to implement the program as policy and procedure would need to be
established and State training would need to be attended, etc.
Nelson will bring additional information to the Board at the January meeting
and will also invite someone from the State to attend the January meeting to
discuss the restaurant inspection process and agent status.
ANNUAL GENERAL RELIEF PROGRAM POLICY REVIEW: Borup said the Board is
required to review the General Relief Program annually. He said we are not
recommending any policy changes this year but have deleted the Medical Needs
Standard dollar amounts as those figures change sometime after the first of the
year.
Motion: A motion was introduced by
Berenschot, seconded by Wentz, and
unanimously adopted: That the Board approves the General Relief Program Policy.
Stephens asked if there were any other issues to bring before the Board.
Motion: A motion was introduced by Horne, seconded by Stephens, and
unanimously adopted: That the meeting be adjourned.
Time: 10:25 a.m.
Chairman: _____________________________
Attest: _________________________________
(Secretary)
